The Health Resources and Services Administration (HRSA) will require new Title III recipients of Ryan White funds to participate in a continuous quality improvement program. The goal of out project is to assess the quality of HIV care provided by participating clinics, changes in such care subsequent to quality training, and the organizational characteristics and policies related to such changes. Specifically, we propose to: 1. Develop reliable, valid, and efficient methods of characterizing physician and nurse characteristics related to the provision of high quality HIV care. This assessment will include collecting information about attitudes and beliefs, formal training and experience, and knowledge. 2. Develop reliable, valid, and efficient methods of characterizing organizational factors that facilitate or inhibit the adoption of strategies for providing high quality care and that predict successful organizational change. 3. Assess the association between clinic and provider characteristics and quality of HIV care prior to an intensive collaborative quality improvement project involving multiple HIV care sites using medical record based measures of quality. 4. Assess the degree to which clinical sites that participate in a quality improvement program achieve greater improvement in core measures of quality of care than clinics that do not participate. The goal of the intervention project will be to focus and accelerate improvement of significant care processes, guided by the best available science. The general approach will be that pioneered by the Institute for Healthcare Improvement under the aegis of its 'breakthrough series' projects. 5. Conduct descriptive analyses of clinician and clinic characteristics that predict which clinics improve the most following the quality improvement intervention. 6. Conduct descriptive analyses of clinician and clinic factors and improvement processes that are associated with sustained change or late improvement.